Articulating ultrasonic surgical instruments and systems

ABSTRACT

An articulating ultrasonic surgical end effector includes a clevis, a transducer housing pivotably coupled to the clevis, an ultrasonic transducer disposed within the transducer housing, a waveguide extending distally from the ultrasonic transducer, an ultrasonic blade disposed at the distal end of the waveguide, a shaft extending distally from the transducer housing about at least a portion of the ultrasonic blade, and a clamp arm pivotably coupled to the shaft and movable relative to the ultrasonic blade between an open position and a clamping position. Ultrasonic energy produced by the ultrasonic transducer is transmitted along the waveguide to the ultrasonic blade for treating tissue therewith.

CROSS REFERENCE TO RELATED APPLICATION

The present application is a continuation of U.S. patent applicationSer. No. 15/345,670, filed on Nov. 8, 2016, which claims the benefit ofand priority to U.S. Provisional Patent Application No. 62/256,354,filed on Nov. 17, 2015, the entire contents of each of which are herebyincorporated herein by reference.

BACKGROUND Technical Field

The present disclosure relates to surgical instruments and systems and,more particularly, to articulating ultrasonic surgical instruments andsystems.

Background of Related Art

Ultrasonic surgical instruments and systems utilize ultrasonic energy,i.e., ultrasonic vibrations, to treat tissue. More specifically, atypical ultrasonic surgical instrument or system includes a transducerconfigured to produce and transmit mechanical vibration energy atultrasonic frequencies along a waveguide to an ultrasonic end effectorconfigured to treat tissue, e.g., coagulate, cauterize, fuse, seal, cut,desiccate, fulgurate, or otherwise treat tissue. Traditionally, thetransducer remains external of the surgical site, while the waveguideextends from the transducer into the surgical site to provide theultrasonic energy to the ultrasonic end effector. The ultrasonic endeffector is manipulated into position to treat a desired tissue ortissues.

Some ultrasonic surgical instruments and systems incorporate rotationfeatures, thus enabling rotation of the ultrasonic end effector to adesired orientation within the surgical site. However, even in suchinstruments and systems, the ability to navigate within the surgicalsite via rotation and manipulation alone is limited.

SUMMARY

As used herein, the term “distal” refers to the portion that is beingdescribed which is further from a user, while the term “proximal” refersto the portion that is being described which is closer to a user.Further, to the extent consistent, any or all of the aspects detailedherein may be used in conjunction with any or all of the other aspectsdetailed herein.

In accordance with aspects of the present disclosure, an articulatingultrasonic surgical end effector is provided including a clevis, atransducer housing pivotably coupled to the clevis, an ultrasonictransducer disposed within the transducer housing, a waveguide extendingdistally from the ultrasonic transducer, an ultrasonic blade disposed atthe distal end of the waveguide, a shaft extending distally from thetransducer housing about at least a portion of the ultrasonic blade, anda clamp arm pivotably coupled to the shaft and movable relative to theultrasonic blade between an open position and a clamping position.Ultrasonic energy produced by the ultrasonic transducer is transmittedalong the waveguide to the ultrasonic blade for treating tissuetherewith.

In aspects of the present disclosure, at least one pulley and cableoperably couples the transducer housing with the clevis to permitpivoting of the transducer housing relative to the clevis.

In aspects of the present disclosure, at least one pulley and cableextends between the clamp arm and the clevis to permit pivoting of theclamp arm relative to the ultrasonic blade regardless of the orientationof the transducer housing relative to the clevis.

In aspects of the present disclosure, the transducer housing ispivotable relative to the clevis within a first plane and the clamp armis pivotable relative to the ultrasonic blade within a second planeperpendicular to the first plane.

In aspects of the present disclosure, the transducer housing ispivotable relative to the clevis within a first plane and the clamp armis pivotable relative to the ultrasonic blade within a second planeparallel to or co-planar with the first plane.

In aspects of the present disclosure, the ultrasonic transducer includesa plurality of piezoelectric elements and a plurality of electrodesinterdisposed between the piezoelectric elements. The ultrasonictransducer, in aspects, defines a circular cross-sectionalconfiguration. Alternatively, the ultrasonic transducer devices arectangular cross-sectional configuration.

A surgical instrument provided in accordance with aspects of the presentdisclosure includes a handle assembly having an elongated body portionextending distally therefrom, and an articulating ultrasonic surgicalend effector according to any of the above aspects, wherein the clevisthereof extends distally from the elongated body portion of the handleassembly.

A surgical system provided in accordance with aspects of the presentdisclosure includes a robotic surgical system having a control deviceand a robotic arm, and an articulating ultrasonic surgical end effectoraccording to any of the above aspects, wherein the clevis extendsdistally from the robotic arm of the robotic surgical system.

BRIEF DESCRIPTION OF THE DRAWINGS

The above and other aspects and features of the present disclosure willbecome more apparent in view of the following detailed description whentaken in conjunction with the accompanying drawings wherein likereference numerals identify similar or identical elements and:

FIG. 1 is a side, perspective view of an endoscopic surgical instrumentconfigured for use in accordance with the aspects and features ofpresent disclosure;

FIG. 2 is a schematic illustration of a robotic surgical systemconfigured for use in accordance with the aspects and features ofpresent disclosure;

FIG. 3A is an enlarged, side, perspective view of an ultrasonicarticulating end effector in accordance with the present disclosure andconfigured for use with the endoscopic surgical instrument of FIG. 1,the robotic surgical system of FIG. 2, or any other suitable surgicalinstrument or system;

FIG. 3B is an enlarged, side, perspective view of another ultrasonicarticulating end effector in accordance with the present disclosure andconfigured for use with the endoscopic surgical instrument of FIG. 1,the robotic surgical system of FIG. 2, or any other suitable surgicalinstrument or system;

FIG. 4 is a side view of the transducer, waveguide, and ultrasonic bladeof the ultrasonic articulating end effector of FIG. 3A;

FIG. 5A is a cross-sectional view of the transducer of the ultrasonicarticulating end effector of FIG. 3A taken across section line 5A-5A ofFIG. 4; and

FIG. 5B is a cross-sectional view of another transducer configured foruse with the ultrasonic articulating end effector of FIG. 3A.

DETAILED DESCRIPTION

Referring generally to FIG. 1, an embodiment of an endoscopic surgicalinstrument exemplifying the aspects and features of the presentdisclosure is shown generally identified by reference numeral 10. Forthe purposes herein, endoscopic surgical instrument 10 is generallydescribed. Aspects and features of endoscopic surgical instrument 10 notgermane to the understanding of the present disclosure are omitted toavoid obscuring the aspects and features of the present disclosure inunnecessary detail.

Endoscopic surgical instrument 10 generally includes a handle assembly12, an elongated body portion 14, and an articulating ultrasonicsurgical end effector 200. End effector 200 is described in greaterdetail below. Handle assembly 12 supports a battery assembly 18 and agenerator assembly 20, and includes a first rotation knob 22, a secondrotation knob 23, an activation button 24, and a clamp trigger 26.

Clamp trigger 26 of endoscopic surgical instrument 10 is selectivelymanipulatable to actuate a motor, other powered drive mechanism, or amanual drive mechanism, e.g., gears, pulleys, tension cables, etc., totransition end effector 200 between an open condition and a clampingcondition, as detailed below.

First rotation knob 22 is selectively manipulatable to rotate elongatedbody portion 14 and, thus, end effector 200 relative to handle assembly12. Second rotation knob 23 is selectively manipulatable to actuate amotor, other powered drive mechanism, or a manual drive mechanism, e.g.,gears, pulleys, tension cables, etc., to articulate end effector 200relative to elongated body portion 12, as detailed below. As analternative to first and second rotation knobs 22, 23, other suitableactuation mechanism, e.g., toggle switches, joysticks, buttons, etc.,may be provided.

Battery assembly 18 and generator assembly 20 cooperate, upon activationof activation button 24, to supply power to end effector 200 to enablethe generation of ultrasonic energy for treating tissue therewith, e.g.,to coagulate, cauterize, fuse, seal, cut, desiccate, fulgurate, orotherwise treat tissue, as detailed below. Battery assembly 18 andgenerator assembly 20 are each releasably secured to handle assembly 12,and are removable therefrom to facilitate disposal of handle assembly12, with the exception of battery assembly 18 and generator 20. However,it is contemplated that any or all of the components of endoscopicsurgical instrument 10 be configured as disposable single-use componentsor sterilizable multi-use components, and/or that endoscopic surgicalinstrument 10 be connectable to a remote power source or generatorrather than having such components on-board.

Referring generally to FIG. 2, an embodiment of a robotic surgicalsystem exemplifying the aspects and features of the present disclosureis shown generally identified by reference numeral 1000. For thepurposes herein, robotic surgical system 1000 is generally described.Aspects and features of robotic surgical system 1000 not germane to theunderstanding of the present disclosure are omitted to avoid obscuringthe aspects and features of the present disclosure in unnecessarydetail.

Robotic surgical system 1000 generally includes a plurality of robotarms 1002, 1003; a control device 1004; and an operating console 1005coupled with control device 1004. Operating console 1005 may include adisplay device 1006, which may be set up in particular to displaythree-dimensional images; and manual input devices 1007, 1008, by meansof which a person (not shown), for example a surgeon, may be able totelemanipulate robot arms 1002, 1003 in a first operating mode. Roboticsurgical system 1000 may be configured for use on a patient 1013 lyingon a patient table 1012 to be treated in a minimally invasive manner.Robotic surgical system 1000 may further include a database 1014, inparticular coupled to control device 1004, in which are stored, forexample, pre-operative data from patient 1013 and/or anatomical atlases.

Each of the robot arms 1002, 1003 may include a plurality of members,which are connected through joints, and an attaching device 1009, 1011,to which may be attached, for example, a surgical tool “ST” supportingan end effector 200, 1100. End effector 200, as noted above with respectto endoscopic surgical instrument 10 (FIG. 1), and as described ingreater detail below, is an articulating ultrasonic surgical endeffector. End effector 1100 may be any other suitable surgical endeffector, e.g., an endoscopic camera, other surgical tool, etc. Robotarms 1002, 1003 may be driven by electric drives, e.g., motors, that areconnected to control device 1004. Control device 1004 (e.g., a computer)may be configured to activate the motors, in particular by means of acomputer program, in such a way that robot arms 1002, 1003, theirattaching devices 1009, 1011, and, thus, the surgical tools “ST”(including end effectors 200, 1100) execute a desired movement and/orfunction according to a corresponding input from manual input devices1007, 1008, respectively. Control device 1004 may also be configured insuch a way that it regulates the movement of robot arms 1002, 1003and/or of the motors.

Turning to FIG. 3A, articulating ultrasonic surgical end effector 200includes a clevis 210 that operably couples end effector 200 to asurgical instrument or system. For example, clevis 210 may be defined atthe distal end of elongated body portion 14 of endoscopic surgicalinstrument 10 (FIG. 1), at the distal end of attaching device 1009 ofrobot arm 1002 of robotic surgical system 1000 (FIG. 2), or at any othersuitable location for enabling use of end effector 200 with acorresponding surgical instrument or system.

Clevis 210 includes a pair of spaced-apart arms 212. Each arm 212defines a distal aperture 216 and a proximal aperture 218. Distalapertures 216 are aligned with one another and proximal apertures 218are aligned with one another. A proximal pulley 222 is disposed adjacenteach proximal aperture 218 on the interior sides of arms 212. Proximalpulleys 222 are rotatably coupled to adjacent arms 212 via pivot pins(not explicitly shown) extending through proximal apertures 218.

Continuing with reference to FIG. 3A, end effector assembly 200 furtherincludes a transducer housing 230, a shaft 240 extending distally fromtransducer housing 230, a clamp arm 250 pivotable relative to shaft 240,a clamp pulley 260 operably coupled to clamp arm 250, and an innerassembly 270 disposed partially within transducer housing 230, extendingthrough shaft 240, and extending distally from shaft 240. Transducerhousing 230 mounts a distal pulley 224 on either side thereof.Transducer housing 230 extends between arms 212 of clevis 210 such thatone of distal pulleys 224 is disposed adjacent each distal apertures 216on the interior sides of arms 212. Distal pulleys 224 are rotatablycoupled to arms 212 via pivot pins (not explicitly shown) extendingthrough distal apertures 216.

Referring still to FIG. 3A, first and second cables 226, 228 are eachrouted about one of the proximal pulleys 222 and are secured to one ofthe distal pulleys 224. More specifically, a distal end of first cable226 is routed about the corresponding distal pulley 224 in a firstdirection and is secured thereto, while a distal end of second cable 228is routed about the corresponding distal pulley 224 and is securedthereto. As a result of this configuration, proximal pulling of firstcable 226 urges the corresponding distal pulley 224 and, thus,transducer housing 230 to pivot relative to clevis 210 in a firstdirection, while proximal pulling of second cable 228 urges thecorresponding distal pulley 224 and, thus, transducer housing 230 topivot relative to clevis 210 in a second, opposite direction.Alternatively, first and second cables 226, 228 may be configured as asingle cable secured to one of the distal pulleys 224, routed about oneof the proximal pulleys 222, and having its two ends extendingproximally from clevis 210.

Shaft 240 of end effector 200 extends distally from transducer housing230 and includes clamp arm 250 pivotably coupled thereto. Clamp pulley260 is engaged with clamp arm 250 and rotatably coupled to the distalend of shaft 240 such that rotation of clamp pulley 260 in a firstdirection relative to shaft 240 pivots clamp arm 250 towards a clampingposition, wherein clamp arm 250 is positioned adjacent ultrasonic blade278 for clamping tissue therebetween, and such that rotation of clamppulley 260 in a second, opposite direction relative to shaft 240 pivotsclamp arm 250 towards an open position, wherein clamp arm 250 isfurther-spaced from ultrasonic blade 278.

Third and fourth cables 262, 264 are routed about proximal pulleys 222,distal pulleys 224, and clamp pulley 260. More specifically, a distalend of third cable 262 is routed about clamp pulley 260 in a firstdirection and is secured thereto, while a distal end of fourth cable 264is routed about clamp pulley 260 in a second direction and is securedthereto. As a result of this configuration, proximal pulling of thirdcable 262 urges clamp pulley 260 to pivot relative to shaft 240 in afirst direction, thereby pivoting clamp arm 250 relative to ultrasonicblade 278 towards the clamping position, while proximal pulling offourth cable 264 urges clamp pulley 260 to pivot relative to shaft 240in a second, opposite direction, thereby pivoting clamp arm 250 relativeto ultrasonic blade 278 towards the open position. Alternatively, thirdand fourth cables 262, 264 may be configured as a single cable securedabout clamp pulley 260 and having its two ends extending proximally fromclamp pulley 260, about proximal and distal pulleys 222, 224, andproximally from clevis 210.

Referring additionally to FIG. 1, with respect to use of end effector200 with endoscopic surgical instrument 10, the proximal ends of first,second, third, and fourth cables 226, 228, 262, 264 of end effector 200extend proximally through elongated body portion 12. The proximal endsof first and second cables 226, 228 are operably coupled to secondrotation knob 23 (or the drive component associated therewith) such thatrotation of second rotation knob 23 in a first direction pivotstransducer housing 230 relative to clevis 210 and elongated body portion12 in a first direction, and such that rotation of second rotation knob23 in a second direction pivots transducer housing 230 relative toclevis 210 and elongated body portion 12 in a second direction. Such aconfiguration enables articulation of clamp arm 250 and ultrasonic blade278 to a desired orientation relative to tissue to be treated.

The proximal ends of third and fourth cables 262, 264 are operablycoupled to clamp trigger 26 such that actuation of clamp trigger 26 froman un-actuated position to an actuated position pivots clamping arm 260from the open position to the clamping position and such that return ofclamp trigger 26 from the actuated position back to the un-actuatedposition pivots clamping arm 260 from the clamping position back to theopen position.

Referring to FIGS. 2 and 3A, with respect to use of end effector 200with robotic surgical system 1000, the proximal ends of first, second,third, and fourth cables 226, 228, 262, 264 of end effector 200 extendproximally through robot arm 1002 and each operably couple to acorresponding motor of control device 1004. Control device 1004 isoperable, depending upon the input instructions received, to drive theappropriate motor thereof to pull the corresponding cable 226, 228, 262,264 to pivot transducer housing 230 relative to clevis 210 in a desireddirection to articulate clamp arm 250 and ultrasonic blade 278 to adesired orientation relative to tissue to be treated, or to pivot clamparm 250 between the open and clamping positions to clamp tissue betweenclamp arm 250 and ultrasonic blade 278.

In the configuration illustrated in FIG. 3A, clamp arm 250 pivotsbetween the open and clamping positions within a first plane andtransducer housing 230 pivots or articulates relative to clevis 210within a second plane that is perpendicular to the first plane.Alternatively, as illustrated in FIG. 3B, an end effector 200′ similarto end effector 200 (FIG. 3A) may be provided wherein clamp arm 250′pivots relative to ultrasonic blade 278′ within a first plane andtransducer housing 230′ pivots relative to clevis 210′ within a secondplane that is parallel or co-planar with the first plane.

Referring to FIGS. 3A and 4, as noted above, inner assembly 270 isdisposed partially within transducer housing 230, extends through shaft240, and extends distally from shaft 240. Inner assembly 270 includes anultrasonic transducer 272 formed from a stack of piezoelectric elements273. Electrodes 274 interdisposed between piezoelectric elements 273 areelectrically coupled to a source of energy, e.g., via lead wires 275extending through the pivots that couple transducer housing 230 withclevis 210 and proximally through the instrument or system to the sourceof energy. Upon energization of electrodes 274, e.g., in response toactivation of activation button 26 of surgical instrument (FIG. 1) or inresponse to an appropriate instruction provided by control device 1004of robotic surgical system 1000 (FIG. 2), piezoelectric elements 273produce ultrasonic energy that is transmitted along waveguide 276, whichextends from ultrasonic transducer 272 distally from transducer housing230 and through shaft 240. Ultrasonic blade 278 extends distally fromwaveguide 276 and distally from shaft 240. Ultrasonic blade 278 ispositioned adjacent clamp arm 250 to enable clamping of tissue betweenultrasonic blade 278 and clamp arm 250 in the clamping position of clamparm 250. Ultrasonic energy transmitted along waveguide 276 to ultrasonicblade 278 is communicated to tissue clamped between clamp arm 250 andultrasonic blade 278 to treat tissue.

Turning now to FIG. 5A, in some embodiments, piezoelectric elements 273of ultrasonic transducer 272 define a generally circular cross-sectionalconfiguration. Alternatively, as illustrated in FIG. 5B, piezoelectricelements 273 of ultrasonic transducer 272 may define a rectangularcross-sectional configuration. The rectangular configuration illustratedin FIG. 5B provides a greater surface area usable to create ultrasonicenergy without requiring an increase in the required dimensions of endeffector 200.

While several embodiments of the disclosure have been shown in thedrawings, it is not intended that the disclosure be limited thereto, asit is intended that the disclosure be as broad in scope as the art willallow and that the specification be read likewise. Therefore, the abovedescription should not be construed as limiting, but merely asexemplifications of particular embodiments. Those skilled in the artwill envision other modifications within the scope and spirit of theclaims appended hereto.

What is claimed is:
 1. An articulating ultrasonic surgical end effector,comprising: a clevis; an end effector assembly, including: an ultrasonicblade configured to receive energy produced by an ultrasonic transducer;and a clamp arm pivotable relative to the ultrasonic blade between anopen position and a clamping position; and a pulley arrangement operablycoupling the end effector assembly with the clevis to permitarticulation of the end effector assembly relative to the clevis, thepulley arrangement including: first and second pulleys; and first andsecond cable sections routed about the first and second pulleys suchthat pulling of the first cable section articulates the end effectorassembly relative to the clevis in a first direction and pulling of thesecond cable section articulates the end effector assembly relative tothe clevis in a second, opposite direction.
 2. The articulatingultrasonic surgical end effector according to claim 1, wherein the endeffector assembly further includes the ultrasonic transducer, theultrasonic blade extending distally from the ultrasonic transducer. 3.The articulating ultrasonic surgical end effector according to claim 2,further comprising a transducer housing retaining the ultrasonictransducer therein, the transducer housing pivotably coupled to theclevis.
 4. The articulating ultrasonic surgical end effector accordingto claim 1, wherein a second pulley arrangement including at least onepulley and cable extends between the clamp arm and the clevis to permitpivoting of the clamp arm relative to the ultrasonic blade regardless ofan articulated position of the end effector assembly relative to theclevis.
 5. The articulating ultrasonic surgical end effector accordingto claim 1, wherein the first and second pulleys are longitudinallyarranged such that the first pulley is more-proximal and the secondpulley is more-distal.
 6. The articulating ultrasonic surgical endeffector according to claim 1, wherein the first and second pulleys aredisposed within the clevis.
 7. An ultrasonic surgical instrument,comprising: a handle assembly having an elongated body portion extendingdistally therefrom; and an articulating ultrasonic surgical endeffector, including: a clevis; an end effector assembly, including: anultrasonic blade configured to receive energy produced by an ultrasonictransducer; and a clamp arm pivotable relative to the ultrasonic bladebetween an open position and a clamping position; and a pulleyarrangement operably coupling the end effector assembly with the clevisto permit articulation of the end effector assembly relative to theclevis, the pulley arrangement including: first and second pulleys; andfirst and second cable sections routed about the first and secondpulleys such that pulling of the first cable section articulates the endeffector assembly relative to the clevis in a first direction andpulling of the second cable section articulates the end effectorassembly relative to the clevis in a second, opposite direction.
 8. Theultrasonic surgical instrument according to claim 7, wherein the endeffector assembly further includes the ultrasonic transducer, theultrasonic blade extending distally from the ultrasonic transducer. 9.The ultrasonic surgical instrument according to claim 8, furthercomprising a transducer housing retaining the ultrasonic transducertherein, the transducer housing pivotably coupled to the clevis.
 10. Theultrasonic surgical instrument according to claim 7, wherein a secondpulley arrangement including at least one pulley and cable extendsbetween the clamp arm and the clevis to permit pivoting of the clamp armrelative to the ultrasonic blade regardless of an articulated positionof the end effector assembly relative to the clevis.
 11. The ultrasonicsurgical instrument according to claim 7, wherein the first and secondpulleys are longitudinally arranged such that the first pulley ismore-proximal and the second pulley is more-distal.
 12. The ultrasonicsurgical instrument according to claim 7, wherein the first and secondpulleys are disposed within the clevis.
 13. An ultrasonic surgicalsystem, comprising: a robotic surgical system including a control deviceand a robotic arm; and an articulating ultrasonic surgical end effector,including: a clevis; an end effector assembly, including: an ultrasonicblade configured to receive energy produced by an ultrasonic transducer;and a clamp arm pivotable relative to the ultrasonic blade between anopen position and a clamping position; and a pulley arrangement operablycoupling the end effector assembly with the clevis to permitarticulation of the end effector assembly relative to the clevis, thepulley arrangement including: first and second pulleys; and first andsecond cable sections routed about the first and second pulleys suchthat pulling of the first cable section articulates the end effectorassembly relative to the clevis in a first direction and pulling of thesecond cable section articulates the end effector assembly relative tothe clevis in a second, opposite direction.
 14. The ultrasonic surgicalsystem according to claim 13, wherein the end effector assembly furtherincludes the ultrasonic transducer, the ultrasonic blade extendingdistally from the ultrasonic transducer.
 15. The ultrasonic surgicalsystem according to claim 14, further comprising a transducer housingretaining the ultrasonic transducer therein, the transducer housingpivotably coupled to the clevis.
 16. The ultrasonic surgical systemaccording to claim 13, wherein a second pulley arrangement including atleast one pulley and cable extends between the clamp arm and the clevisto permit pivoting of the clamp arm relative to the ultrasonic bladeregardless of an articulated position of the end effector assemblyrelative to the clevis.
 17. The ultrasonic surgical system according toclaim 13, wherein the first and second pulleys are longitudinallyarranged such that the first pulley is more-proximal and the secondpulley is more-distal.
 18. The ultrasonic surgical system according toclaim 13, wherein the first and second pulleys are disposed within theclevis.